和营安眠汤联合穴位贴敷治疗营卫不调型失眠的临床观察

Clinical Observation of Heyinganmian Decoction Combined with Acupoint Application in the Treatment of Yingwei Disorder Insomnia

目的观察和营安眠汤联合穴位贴敷治疗营卫不调型失眠的临床效果。方法将符合纳入标准的营卫不调型失眠患者60例随机分为2组,30例/组。治疗组口服和营安眠汤,3次/d,1剂/d,联合穴位贴敷,2次/周,对照组睡前口服艾司唑仑片,1 mg/次,1次/d,临睡前服,2组疗程均为30 d。利用多导睡眠监测仪监测2组患者治疗前后睡眠数据,检测治疗前后5-羟色胺(5-HT),γ-氨基丁酸(GABA),去甲肾上腺素(NE),多巴胺(DA)和褪黑素水平,比较2组治疗前后的临床症状积分、临床疗效、睡眠数据、神经递质含量情况以及治疗后不良反应情况。结果治疗组患者在中医证候疗效、PSQI及各项睡眠时长方面明显优于对照组(P<0.05),2组患者治疗前后5-HT、GABA、NE、DA和褪黑素水平变化有明显差异(P<0.05)。治疗组不良反应发生率为10.0%,对照组不良反应发生率为26.7%(P<0.05)。结论和营安眠汤联合穴位贴敷在PSQI疗效、中医证候疗效、改善睡眠各项时长、调节神经递质等方面,疗效优于艾司唑仑,治疗营卫不调型失眠疗效显著,安全性更高。

Objective To observe the clinical effect of Heyinganmian Decoction combined with acupoint application in the treatment of Yingwei disorder insomnia.Methods A total of 60 patients with Yingwei disorder insomnia who met the inclusion criteria were randomly divided into two groups,30 cases in each group.The treatment group took Heyinganmian Decoction orally,3 times a day,1 dose a day,combined with acupoint application,2 times a week,while the control group took estazolam tablets orally,1 mg once a day before going to bed.Two groups were treated as a course of 30 days.Polysomnography was used to monitor the sleep data of the two groups before and after treatment.The levels of 5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA),norepinephrine(NE),dopamine(DA)and melatonin were detected before and after treatment.The clinical symptom score,clinical efficacy,sleep data,neurotransmitter content and adverse reactions after treatment were compared between the two groups before and after treatment.Results The treatment group was significantly better than the control group in TCM syndrome efficacy,PSQI and sleep duration(P<0.05).There were significant differences in the levels of 5-HT,GABA,NE,DA and melatonin between the two groups before and after treatment(P<0.05).The incidence of adverse reactions was 10.0%in the treatment group and 26.7%in the control group(P<0.05).Conclusion Heyinganmian Decoction combined with acupoint application is superior to estazolam in terms of PSQI efficacy,TCM syndrome efficacy,improvement of sleep duration,regulation of neurotransmitters and other aspects,and has significant efficacy and higher safety in the treatment of Yingwei disorder insomnia.